Posturography is a general term that covers all the techniques used to quantify postural control in an upright stance position—either static or dynamic. Among them, Computerized Dynamic Posturography (CDP), also called Test of Balance (TOB), is a non-invasive specialized clinical assessment technique used to quantify the central nervous system adaptive mechanisms (sensory, motor and central) involved in the control of posture and Balance; both in normal (such as in physical education and sports training) and abnormal conditions (particularly in the diagnosis of balance disorders and physical therapy treatment and postural re-education).
Due to the complex interactions among sensory, motor, and central processes involved in posture and balance, CDP requires different protocols in order to differentiate among the many defects and impairments which may affect the patient's postural control system. Thus, CDP is challenged by using several combinations of visual and support surface stimuli and parameters.
Center of gravity (COG) is an important component of balance and should be assessed when evaluating an individual's posture. COG is often measured with Center of Pressure (COP) because COG is hard to quantify.
According to academic literature, the COG should be located at the midpoint of the base of support if an individual has ideal posture. COP excursion and velocity are indicators of control over COG and are key factors for identifying proper posture and the ability of the individual to maintain balance. COP excursion has been defined in the field as the Euclidean displacement in the anterior/posterior and medial/lateral directions within the base of support (perimeter around the feet). With poor posture and/or exaggerated spinal curvatures it is possible that the COP excursion would increase, which can in turn cause instability as the COP shifts towards the periphery of the base of support.
There are various options for treating balance disorders. One option includes treatment for a disease or disorder that may be contributing to the balance problem, for example, ear infection, stroke, multiple sclerosis, spinal cord injury, Parkinson's Disease, neuromuscular conditions, acquired brain injury, cerebellar dysfunction and/or ataxia. Individual treatment will vary and will be based upon assessment results including symptoms, medical history, general health, and the results of the assessment tests.
Many types of balance disorders will require balance training or rehabilitation, prescribed by a medical practitioner, osteopath, chiropractor, occupational therapist or physiotherapist. Osteopaths, chiropractors and physiotherapists often administer standardized outcome measures as part of their assessment in order to gain useful information and data about a patient's current health status and progress.
Rehabilitation for loss of vestibular function must be customized for each patient as studies show that individuals vary in their sensory dependence and how they compensate for vestibular loss. Control of postural orientation and equilibrium can be significantly improved in patients with bilateral or unilateral vestibular loss as long as it is considered a complex, sensory motor skill that must be learned with appropriate feedback and active, context-specific training.
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